Frankenberger, Roland / Van Meerbeek, Bart
Page 439 - 439

Mendes, Laura Teixeira / Loomans, Bas A. C. / Opdam, Niek J. M. / Silva, Carolina Lopes da / Casagrande, Luciano / Lenzi, Tathiane Larissa
Page 443 - 453
Purpose: To systematically review the literature to determine whether silane combined with adhesive application improves the repair bond strength of direct methacrylate-based resin composites in comparison to the use of an adhesive alone.
Materials and Methods: The literature up to December 2019 was searched through PubMed/MEDLINE, Scopus, and Lilacs databases with no publication year or language limits. From 676 potentially eligible studies, 81 were selected for full-text analysis, and 19 were included in the systematic review. Two reviewers independently selected the studies, extracted data, and assessed the risk of bias. Meta-analyses were conducted using a random effects model to calculate pooled mean differences between adhesive- vs silane-plus-adhesive surface treatments (global meta-analysis) and considering subgroup analyses (immediate and aged repair bond strengths and type of silane – hydrolyzed or nonhydrolyzed). Statistical analyses were performed using RevMan5.3 at a significance level of 5%.
Results: Global meta-analysis showed that the use of silane prior to adhesive application produced significantly higher repair bond strengths (p=0.003). A higher mean difference (effect size: 7.30, 95% CI: 2.91-17.51) between groups was found when nonhydrolyzed silanes were used. The heterogeneity was high. Studies scored between medium and high risk of bias.
Conclusion: An additional silane application step could increase the repair bond strength of methacrylate-based resin composites.

Hahn, Britta / Krastl, Gabriel / Halbleib, Karl / Soliman, Sebastian
Page 455 - 463
Purpose: This case report presents the management of molar incisor hypomineralization (MIH) from the mixed to the permanent dentition stage. Shortly after eruption of hypomineralized teeth, masticatory forces frequently cause rapid enamel breakdown. The MIH Treatment Need Index (MIH-TNI) provides guidelines for the treatment of MIH in relation to how severely the teeth are affected.
Clinical considerations: An 11-year-old patient with permanent teeth affected by MIH was referred to us by his orthodontist for conservative dental treatment before planned orthodontic treatment. The restorative treatment varied according to the degree of severity of the affected teeth and included indirect composite resin restorations on teeth #17 (MIH-TNI 4c), #35 (MIH-TNI 4c) and #37 (MIH-TNI 4b), direct composite resin fillings on teeth #26 (MIH-TNI 2b), #27 (MIH-TNI 2a) and #16 (MIH-TNI 4c) and fissure sealants on teeth #16, 15, 14, 24, 25, 34, 36, 44, 45, 46 and 47. Orthodontic treatment was already started during the restorative phase with a bite-jumping appliance. With the conclusion of the second phase of mixed dentition at age 12, the orthodontist was able to start fixed orthodontic treatment of the maxillary and mandibular arches with all of the child's permanent teeth adequately restored. Orthodontic treatment was completed at age 14. At present, 6 years after initiation of dental treatment, all teeth are still free of decay.
Conclusion: A carefully supervised recall program with early comprehensive care at frequent intervals and adequate, defect-driven restorations depending on how severely the teeth are affected are the basis for a favorable long-term prognosis in patients with MIH.

Hahn, Britta / Wohlrab, Theresa / Frese, Cornelia / Wolff, Diana / Krastl, Gabriel / Büsch, Christopher / Babai, Arian / Schlagenhauf, Ulrich / Soliman, Sebastian
Page 465 - 474
Purpose: This sub-analysis of our multicenter trial was to assess the long-term periodontal health (PH) of teeth, esthetically reshaped by means of direct composite buildups.
Materials and Methods: 198 patients who received 667 direct composite buildups on 585 treated teeth (TT) between 01/2001 and 12/2013 were included. PH was assessed for each TT and for an untreated control tooth (CT) by recording the pocket probing depths (PPD), clinical attachment level (CAL), sulcus bleeding index (SBI), and Turesky's modification of the Quigley Hein plaque index (PI). Statistical analysis was performed using the two-sample Student's t-test and Mann-Whitney U-test. Regression models were performed to check for associations between PH and patients' age, gender, age of the buildups, enlargement range, jaw, and tooth type. The level of significance was set at α = 0.05.
Results: PI scores were significantly (p < 0.001) higher in TT (1.60 ± 0.81) than in CT (1.41 ± 0.81). Differences between TT and CT regarding PPD (TT: 2.14 ± 0.56/CT: 2.18 ± 0.56), CAL (TT: 2.34 ± 1.05/CT: 2.33 ± 0.92), and SBI (TT: 0.41 ± 0.60/CT: 0.41 ± 0.65) were not statistically significant (p > 0.05). The enlargement range of the TT and the tooth type were not associated with PH. Male patients had significantly higher PPDs, CAL, and SBI values than did female patients. CAL and SBI values increased over time for both the TT and CT. CAL, SBI, and PI values were significantly higher in the mandible and the PPD values in the maxilla.
Conclusion: Direct composite buildups made for reshaping, change of color or position of teeth did not impair PH in the long term.

Surmelioglu, Derya / Atilan Yavuz, Sevim / Kolsuz Ozcetin, Halime / Özdemir, Zeyneb Merve / Aydin, Ugur
Page 475 - 482
Purpose: To evaluate the bleaching efficacy and shear bond strength (SBS) of composite restorations performed immediately after bleaching with a newly developed experimental bleaching agent, including 6% hydrogen peroxide (HP), titanium dioxide (TiO2), and/or chitosan (CS).
Materials and Methods: We randomly divided 132 maxillary anterior teeth into 2 study groups, 60 teeth for color analysis and 72 teeth for the SBS test. For color analysis, teeth were divided into 5 subgroups. For SBS analysis, teeth were divided into 6 subgroups according to bleaching agent: group C (control): no bleaching; group 35HP: whiteness 35% HP; group 6HP: 6% HP; group HPC: 6% HP+CS; group HPT: 6% HP+TiO2; group HPTC: 6% HP+ TiO2+CS. The teeth were measured with a spectrophotometer before and 24 h after the bleaching, and calculated with the CIEDE2000 formula. SBS test was evaluated in composite restorations immediately after bleaching, using a universal testing machine. Statistical analysis was performed using ANOVA.
Results: The highest ∆E00 values were observed in group 35HP (4.2 ± 1.2); the lowest value was observed in group 6HP (1.7 ± 0.6) (p < 0.05). The values for groups HPC and HPT were similar to each other and significantly lower than the value for 35HP (p < 0.05 and p > 0.05, respectively). Group HPTC was similar to 35 HP (p > 0.05). For SBS, all groups except those containing chitosan showed significantly decreased bond strength compared to the control (p < 0.05), while groups HPC and HPTC had values similar to the control (p > 0.05). Group C (28.02 ± 6.81) had the highest value, while group 35HP (17.02 ± 7.79) had the lowest SBS value.
Conclusion: With the newly developed agent, the bond strength immediately after bleaching was found to be similar to the control group. Its bleaching efficacy was similar to that of routinely used bleaching agents.